Pay-for-performance does not result in better care, study finds

Hospitals that received financial incentives to follow heart attack guidelines did not necessarily provide better care, a new study found.

Researchers at Duke University compared treatments and outcomes for five conditions at hospitals in a pay-for-performance pilot with hospitals not in the program. Overall, there was no evidence that improvements in in-hospital mortality were incrementally greater at pay-for-performance sites. Results of the three-year study appeared in the Journal of the American Medical Association.

Researchers studied examined factors such as whether heart attack patients were prescribed aspirin, beta-blockers and ACE inhibitors. The researchers also tracked whether patients were advised to quit smoking. Hospitals in the program received bonuses if they reached certain performance levels for a given condition. The Centers for Medicare & Medicaid Services has considered pay-for-performance initiatives in the area of long-term care.

Fecal transplants should be considered for patients with recurrent cases of Clostridium difficile whose symptoms cannot be addressed by antibiotics, the Infectious Diseases Society of America said in new guidelines published Thursday.

Lawmakers took a long-standing industry complaint to the Department of Health and Human Services this week, telling Secretary Alex Azar that Medicare and Medicaid favor opioid prescription over non-addictive alternatives for treating chronic pain.